title: Ergonovine-testing-directed therapy and long-term outcome of sudden-death survivors with no apparent heart disease.
abstract: Coronary artery vasospasm, the most common cause of sudden death in patients with structurally normal hearts, is not well recognized. We describe 2 survivors of sudden death with ergonovine-inducible coronary artery vasospasm successfully treated long term with calcium channel blockers. Of the reported (17 worldwide) patients with documented vasospasm-mediated sudden cardiac death treated with calcium blockers, none have had a recurrent event. This is substantially less than the 6-month sudden-death rate of 18 % of untreated vasospasm. We advocate that ergonovine provocative testing of sudden-death survivors with structurally normal hearts, followed by appropriate therapy with calcium channel blockers, be the standard approach for these highly treatable patients.
authors.affiliation: Division of Cardiology,Veterans Administration Medical Center, University of Cincinnati College of Medicine, Ohio, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Ritchie
authors.forename: C
authors.initials: C
authors.lastname: Hattemer
authors.forename: D
authors.initials: D
authors.lastname: Lenihan
mesh_terms: D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004874:Ergonovine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017741:Survivors
chemical_list: D002121:Calcium Channel Blockers; D004874:Ergonovine